Albertine Donker

Standardized Pediatric Hepcidin Values 231 7 METHODS Study population Participants were consecutively enrolled at the Department of Pediatrics while attending Máxima MC, Veldhoven, the Netherlands (MMC) for either minor surgical interventions (e.g. correction of orchidopexy, removal of osteosynthesis material) or diagnostic procedures (e.g. MRI under sedation). Inclusion criteria were age 0 -<18 years, need for a venipuncture or intravenous drip placement for the purpose of general anesthesia or sedation and both oral and written informed consent for inclusion in the study. Exclusion criteria were known iron deficiency anemia, any systemic underlying disease (malignancy, asthma, diabetes, congenital heart disease, kidney failure, congenital immunodeficiency, etc.), acute infection, trauma or operation <48 hours ago, inflammation, infection (CRP> 5 mg/L), ALT> 40 IU/L or treatment with iron preparations. Children admitted for ear tube insertion, adenotomy or adenotonsillectomy because of recurrent infections of the upper airways were not included in the study. All children that were enrolled in the study visited the hospital for elective surgery or diagnostic procedures. Therefore, none of the children had fever since this is a contra-indication for receiving general anesthesia or sedation. Between July 2016 and April 2018, we obtained informed consent for participation in the study for 317 children. Forty-one children were excluded because of failed blood withdrawal (n=23), CRP > 5 mg/L (n=14), underlying disorders (n=2), double inclusion (n=2), ID (n=4) or IDA (n=6), according to WHO definition: ID, ferritin < 12-15 µg/L; IDA, Hb < 11-13 g/dL in combination with ferritin < 12-15 µg/L; specific cutoffs dependent on age. 32-34 This resulted in the inclusion of 266 healthy children (157 males, 109 females) aged 0.3 -17 years ( Table 1 ). Blood sampling was performed (0.5 mL EDTA tube, 3.5 mL serum tube) before the surgical or diagnostic procedure, between 7:30 AM and 6 PM, after 4-6 hours of fasting because of perioperative fasting guidelines. Participants or their representatives filled out a questionnaire on medical history, general health and medication use as part of the anesthesia screening procedure.